Concussion guidelines for high school athletes and coaches updated

Harford County and the State of Maryland are concerned about the effects of head injuries on young athletes and they have implemented new guidelines for dealing with cases of concussions suffered by high school athletes.

The Maryland State Department of Education (MSDE) and Maryland Public Secondary Schools Athletic Association (MPSSAA), which put forth new practice rules in the summer of 2012 in order to lessen the risk of head injuries and heat illnesses after state legislation was passed, updated their protocols last December on how to deal with concussions suffered by student athletes with a paper titled, "Policies and Programs on Concussions for Public Schools and Youth Sport Programs." Though in place for nearly six months, the rules have yet to effect the high school sports in which head injuries are most prevalent: football and soccer.

According to the paper, which can be viewed on the MPSSAA website, every high school coach must provide written verification that they have received concussion awareness training, and that each student athlete or their guardian has been given concussion awareness literature. Parents and guardians of athletes must also sign a MSDE concussion awareness acknowledgment statement.

Most notably, athletes who suffer a concussion must go through a more thorough recuperation process before they are allowed to play again. After being injured and cleared by a licensed health care provider, the affected student has a six-stage "graduated return to play" protocol to complete, each stage of which must be supervised. The list starts with light aerobic activity, and moves to a fifth stage, which is full participation in practice. If 24 hours pass without a return of symptoms, the athlete can move to the sixth stage, a return to play.

"The new guidelines are just a step up in helping prevent traumatic head injuries," Dave Cesky, head football coach at Fallston, said. "With our team, the seven-day rule has been in effect for a while. If you hit your head, you were done for a week."

Cesky, who is Fallston's Athletic Directory and the longest-tenured football coach in Harford County history, having led the Cougars since the school opened in 1977, and who will kick off his 37th season this fall, said that with head injuries, the level of understanding has increased a great deal since he began his career.

"Me and my coaches, if it has anything to do with injuries, especially head injuries, we go right in line with what the doctors say, because that's very serious," Cesky said. "These new guidelines are more about awareness and understanding than anything. In the past, a kid might have had a minor concussion and we wouldn't have known about it, or they might have been able to say [they] felt okay because they were afraid of having to miss some games. If that happens and they have another concussion when they're supposed to be recovering, then you're in trouble. That's when you can really do damage. The new rules ensure we know when a kid has a concussion, and that they take the time to get better."

Despite spending many years in one of the world's most impact-heavy sports, Cesky estimated he sees only a handful of concussions each season.

"We haven't had that many," he said. "Last year I think we only had two. Usually you see them because of a helmet-to-helmet hit, or because a player gets tackled and hits his head on the ground when it's cold outside, and the field is really hard."

Also revamped were the requirements for county coaches and physical education teachers, who now must be certified on concussion awareness every two years, according to Harford County Athletic Director Ken Zorbach.

"We require all coaches and phys ed teachers to take an online course in concussion awareness," Zorbach said. "Even though the new guidelines don't take effect until next school year, everyone involved with physical education has completed the course. As with CPR training, you have to re-certify yourself every two years."

In the past, students who competed in football, soccer or lacrosse could receive a free, baseline concussion test, with the cost of the tests being taken on by Harford County Public Schools and Medstar Health. This coming school year, that list will be expanded to include participants in two other activities.

"In addition to football, boys and girls soccer, and boys and girls lacrosse, field hockey players and cheerleaders can now have the baseline test done," Zorbach said. "Even though the testing isn't required by the guidelines, we feel it's beneficial to have them done."

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